International Journal of Esthetic Dentistry最新文献

The treatment of gingival recession (GR) unequivocally encompasses the proper identification and management of all etiologic and contributory factors. The presence of high frenulum attachment and short vestibule depth is frequently related to the initiation and progression of GR defects, particularly in the anterior mandible. This technical report presents a bilaminar grafting technique that involves the utilization of a Vestibular Incision Subperiosteal Tunnel Access (VISTA) approach in combination with an internal frenectomy to excise the inner components of the frenulum and muscle insertions. This surgical protocol allows the coronal repositioning of the gingival margin while eliminating the insertion and potential for recurrence of the frenulum attachment and muscle pull. The results of the presented case illustration demonstrate excellent root coverage, including coronal migration of the interproximal papillae. Additionally, the coverage obtained remained stable after 12 months of follow-up.

Aim: The objective of the present study was to compare the masking ability of bleach and opaquer shades applied on discolored substrates using a spectrophotometer.

Materials and methods: A total of 90 samples (6 groups, n = 15) of composite resin disks were prepared with different thicknesses of bleach, opaquer, and shades C3 and A2, as follows: Group I: 2-mm C3, 0.5-mm bleach, 1.5-mm A2; Group II: 2-mm C3, 1-mm bleach, 1-mm A2; Group III: 2-mm C3, 0.5-mm opaquer, 1.5-mm A2; Group IV: 2-mm C3, 1-mm opaquer, 1-mm A2; Group V (positive control): two layers of 2-mm A2; Group VI (negative control): 2-mm C3, 2-mm A2. Three measurements were taken using a Vita Easyshade spectrophotometer. The color differences were measured using the CILAB color system, with the A2 shade as a reference point.

Results: The univariate three-way analysis of variance (ANOVA) with post hoc Bonferroni tests were used to analyze the data. The results showed that the masking ability of the C3 shade composite resin disks was as follows: for opaquer of 1-mm thickness: ∆E = 3.51, P = 1, and for opaquer of 0.5-mm thickness: ∆E = 3.44 P = 1, with acceptable masking ability according to the acceptability threshold (∆E ≤ 3.7). However, the bleach group with 1 mm (∆E = 7.34) and 0.5 mm (∆E = 4.17) thicknesses had lower masking ability.

Conclusions: Within the limitations of this laboratory-based study, the opaquer (0.5 to 1 mm) was shown to mask the discolored substrate more effectively compared with the bleach shade of the same thickness.

Resin infiltration is an alternative for arresting and masking white spot lesions (WSLs). However, depending on their extent, depth, and activity, the voids within their body may not be completely filled by the infiltrant, leaving a certain degree of porosity inside the infiltrated lesion. The two case reports presented in this article aim to propose a modified microabrasion protocol for treating the enamel surface before resin infiltration to improve the esthetic outcome of teeth presenting inactive WSLs. The clinical procedures are described step by step based on data from the scientific literature. The proposed modified microabrasion protocol for treating the enamel surface before resin infiltration of deep inactive WSLs shows promising potential. It effectively improves the esthetics of teeth with inactive WSLs in the treated patients, achieving satisfactory results through a less invasive approach than conventional restorative techniques. However, in vitro and further clinical studies are necessary to analyze the resulting surface loss and verify its effectiveness in treating different enamel developmental defects.

The present case report describes a minimally invasive and multidisciplinary approach to anterior dentition with interproximal spaces and uneven incisal edges using ceramic laminate veneer restorations and a single immediate implant to replace a hopeless primary tooth in the esthetic zone. The patient's chief concerns were to improve her smile and address the mobility of her maxillary right canine. After clinical evaluation, the patient was offered conservative veneers from the maxillary right lateral incisor to the left canine, and extraction of the primary right canine with an immediate implant to replace the missing permanent right canine. A diagnostic wax-up followed by a mock-up provided a visual tentative outcome and led to the patient's approval. Digital implant planning provided the required information for atraumatic tooth extraction, followed by guided implant placement. Additionally, ultrathin ceramic veneers cemented under rubber dam isolation completed the treatment with highly esthetic results. Well-planned restorative and surgical procedures with minimally invasive veneers and immediate implant therapy achieved the desired outcome in the esthetic zone and were still successful at the 3-year follow-up.

Aim: To evaluate the accuracy of digital scans made under heavy-gauge latex rubber dam isolation for single-tooth indirect bonded posterior restorations on first molars by assessing the firmness of the proximal contact (PC) after delivery.

Materials and methods: In the present retrospective study, partial-bonded leucite-reinforced feldspathic ceramic indirect restorations with the inclusion of the mesial and distal contact points were prepared on first molars under heavy-gauge latex rubber dam isolation. Two groups were compared: in group W, the teeth were held in their initial position using interproximal wedges; in group NW, the teeth were free to migrate under the tension produced by the rubber dam. A digital scan under rubber dam was taken for both groups, and the restorations were made by one dental technician. After delivery, the firmness of the restorations' PCs was evaluated. The chi-square test was used with a significance level of 5%.

Results: Forty partial-bonded leucite-reinforced feldspathic ceramic indirect restorations were included in the present study, 20 in group W and 20 in group NW (N = 40 patients; 19 maxillary molars and 21 mandibular molars). Evaluations performed 6 months after delivery demonstrated that the restorations in group W showed significantly better (P 0.01) PCs than those in group NW.

Conclusions: Heavy-gauge rubber dam induces tooth migration, which impairs the PC of indirect bonded restorations. Scanning under rubber dam allows precise PCs to be achieved when the prepared teeth are held in their initial position by interproximal wedges.